The Age of Polio: How an Old Virus and New Toxins Triggered a Man-made Epidemic -- Part 6, After: The Persistence of Polio
To summarize our theory: Polio is a virus, contagious like other viruses, and generally a harmless enterovirus. When it is introduced into the human body, it has the capacity to enter the nervous system when nerves are damaged. Damage can occur many ways: mechanically through needle puncture or surgery, or, we propose, biochemically via pesticidal or other toxic exposure. Once the virus enters the nervous system, it becomes dangerous in a way nature never allowed before. It spreads through the nervous system via "retrograde axonal transport." The resulting damage can lead to paralysis or death.
Two regions of the world continue to experience polio outbreaks, despite hopes the virus would be eradicated by 2000. This persistence has surprised and confused the experts.
“The eradication campaign has been stalled from about 2002 to 2007 … Why is it so difficult to complete the global eradication of wild poliovirus?” asked Neal Nathanson of the University of Pennsylvania School of Medicine in a 2008 medical review, “The Pathogenesis of Poliomyelitis: What We Don’t Know.”[i] (What we don’t know turns out to be a lot – the paper runs to 50 pages.)
“Currently, there are two epicenters that have resisted virus elimination, one in South Asia (Afghanistan, Pakistan, northern India) and one in West Africa (centered in Nigeria). What explains the persistence of wild polioviruses in these two foci?”
Nathanson cites three possibilities: those are warm climates, so poliovirus doesn’t go dormant in the winter as it theoretically did in other countries; the prevalence of other enteroviruses means that the live-virus polio vaccine is not as effective because the other viruses interfere with it; and poor public health infrastructure couple with fears about vaccination made the achievement of “herd immunity” harder than expected.
If one considers the toxin idea, however, another explanation jumps out, especially in South Asia. Erase national borders for a moment. While outbreaks are small and have waxed and waned over the past decade, the primary sites have been directly south of the Himalayan range in a smiley-face arc that runs west from Nepal and Bangladesh, through the Northern India districts of West Bengal, Bihar and Uttar Pradesh, into Pakistan and Afghanistan.
This also happens to be the area with the worst mass poisoning from arsenic in human history. This is not ancient history – it didn’t even begin until the 1980s. It is a story of the single-minded war against microbes gone badly wrong. What happened is beautifully outlined in an American Scientist article, “No one checked: Natural Arsenic in Wells.”[ii]
“The wells that now supply the people's drinking water are sealed from bacterial contamination; their tight concrete tubes reach down 60 feet or more, past surface contamination,” write Phillip and Phylis Morrison. “The big investment in concrete wells, originally made by UNICEF and the World Bank, has beaten back diarrheal diseases, making a real contribution to the vigor and quality of life of the people here.”
But what no one checked was the possibility of another kind of contamination: the wells tapped into the deeper water table and pulled up arsenic that had been swept down the Himalayan watershed by the Ganges and Indus Rivers, both of which drain both slopes of the mighty range.
And that proved to be a catastrophic failure. “A new calamity as astonishing as it is threatening confronts the country people of the Bengal Basin,” the Morrisons write – a calamity that has continued to spread through India and westward. “The drinking water, though sealed from infection, can hold a chronic dose of invisible, tasteless, odor-free dissolved arsenic. … That trace presence is a public poison.”
In Bangladesh alone, the World Health Organization calls arsenic contamination of drinking water “the largest mass poisoning of a population in history” (an eerie echo of Biskind calling DDT use “the most intensive campaign of mass poisoning in human history”). In focusing solely on microbes, in failing understand the ecology they were tapping into, public health experts failed in their due diligence – “no one checked,” and so they simply missed the risk from the toxin. In a deep and disturbing irony, we believe that this arsenic exposure – born of a sincere but disastrously conceived effort to protect people from dangerous microbes -- has also led to the persistence of poliomyelitis.
On May 12, 2010, Bill Gates boarded a boat in the city of Patna, on the Ganges River in the Indian province of Bihar, and traveled 140 miles east to the small village of Guleria. He was there to personally take the Gates Foundation’s fight against polio into the heart of the beast. Bihar is “one of only two Indian States where new cases of polio continue to be reported, according to UNICEF. Uttar Pradesh is the other.”[iii]
This is also arsenic country. The districts on both sides of the Ganges, including Patna and Khagara, are among the 16 worst arsenic-affected districts in Bihar.[iv] In neighboring Uttar Pradesh, “as many as 20 districts have alarmingly high arsenic content in the groundwater and the state government is at its wits end.”[v]
The consequences include lesions on the hands and feet, intestinal problems, and cancer that can kill. In India, “the spread of arsenic contamination in groundwater seems to be assuming gargantuan proportions,” reported Current Science in 2005. “What is worse is that inhabitants of the affected areas are unaware and the local authorities totally oblivious to this grave problem. It was known that West Bengal (WB) and Bangladesh had high levels of arsenic in the groundwater, but slowly the problem is spreading to other states like Uttar Pradesh. This is confirmed by the reports of All India Institute of Medical Sciences, New Delhi that people living in the Ballia district of UP also have high levels of arsenic in their blood, hair, nails, etc.”[vi]
This convergence has totally escaped the polio fighters, just as the arsenic risk from deeper wells escaped the planners (ironically, those planners include the same World Health Organization now combating poliomyelitis there). “Most parts of India are polio free. Of the 35 states and Union Territories, 33 have stopped indigenous polio virus transmission. Only Uttar Pradesh (UP) and Bihar remain endemic for polio virus because of the uniquely challenging conditions like poor environmental sanitation, high population density, high birth rate which make them the most challenging places on earth to eradicate polio.”[vii]
But do those factors really make the two areas “unique” in all India? And why does the polio arc sweep across the same arsenic-poisoned swath of neighboring countries?
At the proverbial 30,000-foot level – Himalayan height, as it happens -- the theory makes sense. But it also holds up on the ground. District by district, city by city, the dots connect.
-- In West Bengal, Howrah District was singled out for high arsenic contamination[viii] – and polio. A case of poliovirus reported there in April “has shocked the World Health Organization, UNICELF, Rotary International and the government itself.”[ix]
-- In Pakistan, “Another polio case in Muzaffargarh”[x] coincides with the fact that “arsenic was recently found in Pakistan, in and around Muzaffargarh on the south-western edge of the Punjab.”[xi]
-- In Afghanistan, half a million people are potentially at risk from arsenic poisoning, and the country is one of four where poliovirus remains endemic.
Why, given the arsenic disaster in Bangladesh, are there no recent polio cases there? It appears the virus has been wiped out. “Concerted efforts to eradicate polio in Bangladesh, resulted in the country being declared polio free in August 2000.”[xii]
Arsenic abatement also has been attacked most aggressively in Bangladesh, where the problem first surfaced. “In Bangladesh and West Bengal, at present less people are drinking arsenic contaminated water due to growing awareness and access to arsenic safe water. But no doubt the problem would not have attained such gravity, if it were not ignored for quite a long time. Unfortunately today similar mistakes are being repeated in Bihar, UP, Jharkhand, and Assam where still the villagers are drinking contaminated water. Non recognition of truth continues.”[xiii]
Indeed it does. Polio outbreaks, we believe, are persisting today for the same reason they arose. South Asia is simply a place where toxic interactions are triggering outbreaks that highlight the presence of the virus, like Luminol bringing out hidden blood splatters at a crime scene.
That would seem to spell trouble for programs guided by the belief that going after polio outbreaks will eradicate the virus – despite the vast resources currently being thrown at the effort.
On January 31, Bill Gates spoke at the Roosevelt House in Manhattan – “Bill Gates Channels Franklin Roosevelt,” as one news service put it -- where FDR recuperated after being stricken at Campobello. Gates said his foundation is making polio eradication its top priority because “it is the thing we can do to most improve the human condition.” He set a goal of 2013 but said, “Eradication is not guaranteed. It requires campaigns to give polio vaccine to all children under 5 in poor countries, at a cost of almost $1 billion per year.” [xiv]
Polio eradication itself is a controversial priority. Bill Gate’s own vanity – a heroic effort to make as big an impact on the technological destruction of disease as he did on the technology of computer software – has driven his poliovirus campaign, but many public health advocates grumble that it’s a low priority. Millions die every year from preventable diseases ranging from pneumonia to diarrhea.
“As Bill Gates presses forward in a costly mission to eliminate the disease, some eradication experts and bioethicists ask if it’s right to keep trying,” reported The New York Times in February 2011. “As new outbreaks create new setbacks each year, he has given ever more money, not only for research but for the grinding work on the ground.”
“We ought to admit that the best we can achieve is control,” argued Arthur L. Caplan, director of the University of Pennsylvania bioethics center, who had polio as a child. Gates calls his critics “cynics” who are “accepting 100,000 to 200,000 crippled or dead children a year” if polio resurges.
We believe a more cost-effective way to reduce and contain poliomyelitis outbreaks – as well as improve total health outcomes -- would be an all-out effort to reduce arsenic contamination and make sure people in South Asia have safe drinking water.
(Next: "Where was God?" -- Lessons learned and Lost)
Dan Olmsted is Editor and Mark Blaxill is Editor-At-Large of Age of Autism. They are co-authors of The Age of Autism -- Mercury, Medicine and a Man-made Epidemic.
[i] Neal Nathanson, “The Pathogenesis of Poliomyelitis – What We Don’t Know.” Advances in Virus Research, Volume 71, 2008.
[ii] Philip and Phylis Morrison, “Natural Arsenic in Wells: No One Checked,” American Scientist, Volume 90, March-April 2002. http://www.americanscientist.org/issues/pub/no-one-checked-natural-arsenic-in-wells
[iii] The Associated Press, “Bill Gates checks on polio progress in India,” May 12, 2010. http://www.usatoday.com/news/health/2010-05-13-bill-gates-india-polio_N.htm
[iv] Dr. Ashok Ghosh, “Arsenic Contamination of Ground Water in Bihar, India, slide presentation,” A.N. College, Patna. http://www.slideshare.net/ghosh51/arsenic-in-ground-water-of-bihar. See slide 16 for extent of arsenic poisoning along Ganges in Bihar.
[v] India News Service, “20 Uttar Pradesh Districts Have High Arsenic in Groundwater,” March 7, 2008.
[vi]“Arsenic – India’s health crisis attracting global attention,” Current Science, Vol. 88 No. 5, March 10, 2005. http://www.ias.ac.in/currsci/mar102005/683.pdf
[vii] Uttar Pradesh State Report, http://mohfw.nic.in/NRHM/Documents/High_Focus_Reports/UP_Report.pdf
[viii]“Groundwater arsenic contamination status of Howrah district, one of the nine arsenic affected districts of West Bengal-India.” School of Environmental Studies, Jadavpur University.
[ix] "Polio Breaks in West Bengal AGAIN!” April 16, 2011, http://puthu.blogspot.com/2011/04/polio-breaks-in-west-bengal-again.html
[x] “Another polio case in Muzaffargarh,” Dawn.com, November 27, 2009. http://archives.dawn.com/archives/139235
[xi]“Pakistan: Arsenic threat to drinking water spreads.” WASH News and Features, February 11, 2005.
[xii] “Polio eradication in Bangladesh.” The Newsletter of the Regional Office for South-East Asia, World Health Organization,
[xiii]“Worsening Arsenic contamination in Bihar: another Bengal delta calamity in the making?”
[xiv] Jason Gale and Michael Waldholz, “Bill Gates Channels Franklin Roosevelt in Push to Eradicate Global Polio,” Bloomberg News, January 31, 2011. http://www.bloomberg.com/news/2011-01-31/bill-gates-channels-franklin-roosevelt-in-push-to-eradicate-global-polio.html